Advances in Implantation Otology

Review by Anirvan Banerjee MBBS, FRCS(ENT), FRCSEd(ORL-HNS)
Middlesbrough, UK

I must open this review by expressing my thanks to Anirvan Banerjee for such an insightful review, carried out so promptly, and that over the Christmas holiday as well. Readers may have noticed that I perform many of the reviews personally, however ignorant of the book topic I might be. An early, indeed any a review, is so important to the publishers and we all know how busy are clinicians. Such tasks can, understandably, be subject to procrastination. This book did need an expert review, and I just knew I could count on my friend and former colleague, Anirvan.
A word of thanks also to Daniela Rohrmann at Springer Nature for providing a hardback copy of the book for review. Many a publisher will now only offer eBooks, perhaps reflecting that times are hard, but I generally avoid them. Such books are fine for dipping into and quick reference, but it is hardy soul that can read a book from cover to cover off a monitor. I hope this book does well, coming from a publisher that has contributed so much to our speciality.

Liam Flood FRCS FRCSI
Middlesbrough, UK

This substantial, multi-author volume sets out to provide a wide-ranging account of contemporary implantation otology. Rather than focusing solely on cochlear implantation, it brings together cochlear, bone conduction, middle ear, brainstem and vestibular implants within a single text, with contributions from surgeons, audiologists and rehabilitation specialists. The editors clearly intend this to be a comprehensive reference for clinicians already working in the field, or for trainees moving towards an implant-focused career.

The book opens with chapters on auditory and vestibular anatomy, physiology and imaging. These early sections are pitched at readers who already have a baseline familiarity with otological practice but wish to consolidate the structural and radiological detail that underpins safe implantation. They provide useful context for the device-specific material that follows and should be particularly helpful for senior trainees and fellows who are starting to interpret imaging with an “implant surgeon’s eye”.

Cochlear implantation naturally occupies a large proportion of the volume. The chapters follow the clinical pathway in a sensible sequence: indications and pre-operative assessment, surgical approaches and technique, intra- and post-operative complications, and long-term device management. The inclusion of material on signal processing, coding strategies and programming philosophies is especially welcome. Many surgical texts treat these topics only superficially; here, they are discussed with enough depth to give surgeons a better understanding of what their audiology colleagues are trying to achieve at the programming station, and why certain intra-operative decisions have consequences for later fitting.

Bone conduction and middle ear implants are treated as first-class citizens, rather than short add-ons to a cochlear implant book. The audiological indications, surgical nuances and follow-up issues for these devices are described in separate chapters, mirroring the way real implant services tend to organise themselves. For centres where such technologies are available but less frequently used, these sections will serve as a useful orientation and as a starting point for more detailed reading.

A distinguishing feature of the volume is its inclusion of auditory brainstem and midbrain implants, together with discussion of vestibular implantation. These remain specialised interventions, and the chapters are necessarily more introductory than definitive, but they provide a valuable overview of indications, broad technical principles and outcome expectations. For most readers, this will be enough to frame a general understanding of where these devices sit in the therapeutic landscape and to recognise when referral to highly specialised centres may be appropriate.

The editors are also to be commended for devoting space to the “soft” but crucial aspects of implantation. There are chapters addressing neuroplasticity in implanted patients and the ways in which central auditory pathways adapt over time. Speech, language and communication therapy after implantation is considered in its own right, rather than being relegated to a short section at the end of a surgical chapter. The emphasis on functional outcomes and longer-term adaptation helps to balance the more technical content and reflects how multidisciplinary teams now judge success.

As with any large edited work, the quality of writing and depth of coverage vary between chapters. Some sections read as clear, structured teaching pieces with good use of figures and tables; others are closer to narrative reviews or overviews and are less tightly argued. Readers should not expect uniformity of style or granularity across all topics. That said, the overall standard is good, and most contributors manage to combine practical detail with a reasonable account of the supporting evidence.

One inevitable limitation, given the pace of change in implant technology, is that device-specific information will date. Details of processor generations, coding options and recommended programming protocols are likely to evolve faster than the underlying principles of candidacy, implantation and rehabilitation. Clinicians looking for very current guidance on particular systems will still need to consult recent guidelines, consensus documents and manufacturer material. The book is best used for conceptual orientation and as a framework into which more up-to-date technical information can be placed.

The intended readership is clearly clinicians already engaged in, or moving into, implant practice. It is unlikely to serve as an introductory text for undergraduates or junior trainees, but it will be of considerable value to senior trainees, fellows and early-career consultants in otology, to audiologists working in implant programmes, and to speech and language therapists with a strong interest in this patient group. For departments, it lends itself well to use as a core library text around which journal clubs, seminar series or multidisciplinary teaching sessions can be structured.

In summary, Advances in Implantation Otology offers a broad, coherent snapshot of the field in the mid-2020s. Its chief strengths are its genuine multidisciplinary perspective and its commitment to treating the full spectrum of implantable devices as part of a single therapeutic ecosystem. No textbook can remain entirely contemporary in such a rapidly advancing area, but as a comprehensive reference and teaching resource it will be a worthwhile addition to the shelves of implant centres and to the personal libraries of clinicians with a sustained interest in this domain.

Amazon Link: Advances in Implantation Otology
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